Team Lead, Insurance Billing

Overview

Team Lead, Patient Financial Services Follow up, Days, 80 Hrs / 2wks

Location:

Janesville, WI, or Rockford, IL. Hybrid remote optional as well and flexible work schedule available.

Works in collaboration with the leadership team on communicating follow-up policies, procedures and providing department workflow training to all partners. Conducts performance audits and provides respective partner feedback along with additional training as needed to help support in partner development. Works all advanced functions within Epic and performs other duties as assigned.

• Serves as a Subject Matter Expert (SME) with regards to the insurance follow-up processes and the respective Patient Financial Services Follow-up role, maintaining advanced knowledge of payor updates including Federal and State guidelines, department workflows and resources needed to resolve payor rejections and troubleshoot identified denial trends.
• Knowledgeable in the Single Billing Office for both Hospital Billing and Professional Billing environments within Epic.
• Conducts and manages all department workflow training for new hires to ensure the 90-day standards are successfully met.
• Escalates and follows up with various Mercyhealth departments on any open and unresolved items to assure timely submissions on outstanding claims.
• Monitors and works interdepartmental communication work queues to help ensure timely follow-up and resolution of department items and patient open items.
• Investigates and works identified payor trends to help present a recommended resolution to improve payment outcomes.
• Develops written workflows and job aids to help provide additional resources to Follow-Up Representatives.
• Partners with the Revenue Cycle Training department to host shadowing sessions for new partner orientations to help aid in sharing general knowledge about the role and impact it has within the revenue cycle.
• Assists with the review and approval of department adjustment requests, ensuring appropriate follow-up was completed and correct adjustment codes were selected, providing partner feedback where applicable.
• Researches and provides ongoing partner education regarding regulatory compliance and requirements for claim submission.
• Ensures accurate and timely completion of daily tasks and projects.
• Works with the supervisor to develop and maintain individual and work group statistics that measure quality and productivity.
• Performs partner audits on a regular basis to ensure quality and accuracy of partner work product.
• When applicable, identifies and takes appropriate action to resolve problems to ensure that Mercyhealth obtains expected reimbursement. Brings workflow discrepancies to the attention of a supervisor or manager.
• Provides daily support to work group partners by being available to answer questions and give direction on workload.
• On occasion, with the coordination of a supervisor, adjusts workload.
• In-depth knowledge of Revenue Cycle applications and websites.
• Serves as a backup to other leads within their team, assisting as needed.
• Special projects as assigned.

High school diploma or equivalent required. Associates degree in a business or healthcare field preferred. Five years of healthcare experience required, with emphasis in billing, insurance, collections, registration, scheduling, or customer service.

Epic billing or HFMA CRC certification or comparable certification

• Mercyhealth offers a comprehensive benefits package including medical, dental, and vision insurance options, life and disability coverage, retirement plan options, flexible spending accounts, and other voluntary benefit options.
• Competitive compensation with market rates and available shift differentials and incentive programs.
• Paid Time Off with accumulation based on milestones for work-life balance.
• Educational assistance programs and career ladders to support advancement within Mercyhealth.
• Employee wellbeing resources including a wellbeing mobile application and health risk assessment.
• Additional benefits such as employee assistance programs, employee discounts, paid parental and caregiver leaves, on-demand pay, and financial education resources.